Farhad O. Moola MD, Inc. Orthopedic Surgery （Farhad o .金钱MD公司整形手术）.pdf

Farhad O. Moola MD, Inc. Orthopedic Surgery University of British Columbia Trauma • Hand Surgery • Shoulder Elbow Reconstruction _______________________________________________________ Scapular Stabilizing Muscles: Rehabilitation Protocol Considerations • Why is the scapula important? Normal shoulder motion involves a coordinated rhythm between movement of the shoulder blade on the chest wall and movement of the ball in the shoulder socket. This is called the “scapulohumeral rhythm.” Because the shoulder socket is part of the scapula, many conditions involving the shoulder joint cause secondary problems related to scapular motion and position. These secondary problems can, in turn, worsen the primary condition. • What is scapular dyskinesia?: This term refers to abnormalities in the rhythm of movement between the shoulder blade and ball and socket joint. It often goes unrecognized in the treatment of shoulder conditions such as impingement syndrome, rotator cuff tendinosis and shoulder instability. It may result from fatigue of the shoulder girdle muscles, pain-mediated muscle inhibition or stiffness about the shoulder joint. • Why is scapular dyskinesia important?: The scapula functions to provide a stable foundation through which energy can be transferred from the legs and trunk to the arm and hand. This linkage is called the kinetic chain. Scapular dyskinesia may result in ineffective energy transfer, placing added stress on the tissues around the shoulder which must compensate for a weak link in the chain. This added stress may result in further muscle fatigue and tissue injury about the shoulder. Restoring a stable scapular base is essential to rehabilitating the shoulder and returning to functional activities. The position and movement of the scapula on the chest also controls the orientation of the shoulder socket relative to the ball and the orientation of the acromion bone relative to the rotator cuff tendons. Any abnormality of